Entre o singular e o coletivo: a experiência de um serviço na abordagem das anorexias e bulimias

Abstract

Investiga-se o manejo das dimensões do coletivo e do singular no âmbito de serviços de saúde orientados, ou, senão, tensionados pela psicanálise. A discussão teórica é sustentada pela descrição de um serviço público voltado para a atenção a sujeitos com diagnóstico de bulimia e/ou anorexia, cuja orientação clínica é dada pela construção dos casos, em equipe interdisciplinar. Os dados foram obtidos através de consultas a documentos do serviço e por meio da observação e participação direta em suas atividades clínicas. Evidencia-se o privilégio dado nesse serviço à singularidade na clínica como forma de tratamento das particularidades do coletivo em questão.

Sobre anorexias e bulimias: concepções e suposições etiológicas na perspectiva dos profissionais de Saúde

“…In this sense, the "radical refusal" present in subjects with anorexic symptoms was highlighted. In fact, as previously demonstrated in other studies 2,6,10,14 , both the pathological status of these practices and the treatment are persistently rejected.…”

“…In fact, it is observed that the reduction of these conditions to the phenomena highlighted by the current psychiatric manuals corroborates a logic of treatment strongly focused on the adjustment of food, weight and satisfaction with the image. This type of approach, however, is limited, since it disregards the subjective and singular aspects of the subject 6 .…”

“…In fact, what is observed is that they are, definitely, not similar to the models and are outside the logic of sharing socially constructed values. From the point of view of psychoanalysis, what is at stake is an autoerotic psychic satisfaction that does not pass through the other and, therefore, breaks up with the social bond 6 .…”

“…Even though, from the epidemiological point of view, complete syndromes are rare in the general population, their prevalence rates among adolescents and young female adults are outstanding 1,2,[4][5][6] . Anorexia nervosa is the third most common chronic disease in adolescence, and among all psychiatric conditions, it is the one with the highest mortality rates.…”

“…The psychic and organic manifestations of these health conditions are delicate and require careful attention from health professionals 2 . However, clinical practice and literature 3,6,[10][11][12] , show that this approach is often inadequate. In general, subjects resist seeking help, and when they do, they neither feel welcomed nor adhere to treatments.…”